also involve recommending a developmental evalua-
tion for a child who is developmentally delayed or
recommending medical and behavioral treatment for
depression.
Further treatment usually involves obtaining
mental health services or additional services for the
family. The goals of these services are to assist the
child and family in coping with the maltreatment and
to restore family functioning. Mental health services
can be directed to the child or to the child’s caretak-
ers, if the child is too young or unable to participate
actively in treatment sessions on her own. Play thera-
py is very commonly employed in this setting. For the
family, evaluating the home environment and the
circumstances surrounding the abuse or neglect is
critical to assisting the family and preventing mal-
treatment from reoccurring. There may be social ser-
vices such as food stamps or parenting education that
can assist the family and reduce family stressors. Par-
ents and caregivers may also be prior victims of child
maltreatment and/or violence in other forms and
benefit from mental health, substance abuse, or do-
mestic violence resources themselves.
Consequences of Maltreatment
The consequences of maltreatment for children
who are abused or neglected vary a great deal. There
are many factors that affect what happens after mal-
treatment, including: the developmental stage of the
child at the time of the abuse or neglect, the type and
chronicity of abuse or neglect, the relationship of the
perpetrator to the child, and the child’s temperament
and natural ability (intelligence). There are also sev-
eral different categories of consequences, including:
medical or physical consequences; emotional, behav-
ioral, or cognitive consequences; short-term versus
long-term consequences; and consequences with or
without intervention by social services or others.
One significant principle that appears in the
child maltreatment literature repeatedly is that chil-
dren suffering multiple types of abuse or neglect tend
to have a poorer outcome than children who suffer
only one type or incident of abuse or neglect. Studies
that document the long-term effects of child abuse
and neglect mirror these findings. These studies show
that lifestyle choices and responses to stress may be
altered, leading to greater risk for adult criminal be-
havior and significant health problems (such as heart
disease) in adulthood.
Prevention of Maltreatment
Unfortunately, there is little data on how to pre-
vent child maltreatment. Home visiting programs
have shown the most promise in the primary preven-
tion of maltreatment, which is preventing abuse or
neglect before it occurs. Home visiting programs in-
volve pairing new parents with someone trained or
experienced in child development so that the new
parents can learn how to care for and respond to the
needs of their infants. The most widely modeled pro-
grams, when studied, have been successful in reduc-
ing the incidence of but have not entirely eliminated
child maltreatment in the study populations. Issues of
funding in many geographic regions have limited the
availability of such services to those families consid-
ered at higher risk for maltreatment.
Efforts in the prevention of maltreatment pri-
marily function on the level of secondary prevention.
Intervention by social services or other professionals
occurs when maltreatment has already taken place or
when children are considered already at risk for abuse
or neglect. In these situations the focus is on prevent-
ing further abuse or neglect, as well as treating and
minimizing complications of the maltreatment that
has occurred.
There is no doubt that prevention of child mal-
treatment is a complex issue. There are multiple fac-
tors involved when a child is abused or neglected,
factors related to the individual child, the family
structure, and other environmental stressors (such as
poverty). The cycle of violence is a well-known phe-
nomenon, where today’s victims become tomorrow’s
perpetrators. In order to prevent child maltreatment,
prevention itself must become a priority. This will re-
quire commitment and collaboration from many
sources, including individuals, professionals, commu-
nity groups, and government agencies. All of these
sources must be willing to work together to make a
difference for children.See also: DOMESTIC VIOLENCEBibliography
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